Prognostic significance of soft tissue deposits in laryngeal carcinoma / Importância prognóstica de depósitos de tecido mole no carcinoma laríngeo

Abstract Introduction: Soft tissue deposits is tumorous islands apart from lymph nodes and occasionally diagnosed in neck dissection specimens. Their importance has begun to be recognized, however, their value has not been investigated in laryngeal cancer as a single tumor site. Objective: To investigate the prognostic value of soft tissue deposits in patients with laryngeal carcinoma. Methods: Medical records of 194 patients with laryngeal carcinoma who were treated primarily by surgery and neck dissection were reviewed. Prognostic significance of soft tissue deposits was assessed along with other clinical and pathological findings. Recurrence rates, overall and disease-specific survival rates were examined. Results: The incidence of soft tissue deposits was found to be 7.2% in laryngeal carcinoma. N stage was more advanced in patients who had soft tissue deposits. Regional recurrence rate was higher and disease specific and overall survivals rates were significantly lower in patients with soft tissue deposits in univariate analysis. However, in multivariate analysis, soft tissue deposits were not found as an independent risk factor. Conclusion: In laryngeal carcinoma, soft tissue deposits was diagnosed in patients with more advanced neck disease and their significance was lesser than other factors including extranodal extension.

Resumo Introdução: Depósitos de tecido mole são ilhas tumorais diferente dos linfonodos e ocasionalmente diagnosticados em amostras de esvaziamento cervical. Sua importância começou a ser reconhecida, mas seu valor não foi investigado no câncer de laringe como um único local de tumor. Objetivo: Investigar o valor prognóstico do depósito de tecido mole em pacientes com carcinoma laríngeo. Método: Os prontuários de 194 pacientes com carcinoma laríngeo tratados principalmente por cirurgia e esvaziamento cervical foram analisados. O significado prognóstico dos depósitos de tecido mole foi avaliado juntamente com outros achados clínicos e histopatológicos. As taxas de recidiva, as taxas de sobrevida geral e específicas da doença foram avaliadas. Resultados: Observou-se uma incidência de depósitos de tecido mole de 7,2% no carcinoma laríngeo. O estágio N foi mais avançado em pacientes com depósitos de tecido mole. A taxa de recorrência regional foi maior e as taxas de sobrevida geral e específica da doença foram significativamente menores nesses pacientes na análise univariada. No entanto, na análise multivariada, o depósito de tecido mole não foi observado como um fator de risco independente. Conclusão: No carcinoma laríngeo, o depósito de tecido mole foi diagnosticado em pacientes com doença cervical mais avançada, mas sua significância foi menor do que outros fatores, inclusive a extensão extranodal.

Needle tract seeding following percutaneous biopsy of renal cell carcinoma

A 66-year-old man underwent computed tomography-guided needle biopsy of a suspicious renal mass. Two months later he underwent partial nephrectomy. Histology revealed a 30-mm clear cell renal cell carcinoma, up to Fuhrman grade 3. An area of the capsule was interrupted, which corresponded to a hemorrhagic area on the cortical surface. Under microscopy, this area showed a tongue of tumor tissue protruding through the renal capsule. A tumor deposit was found in the perinephric fat. These features suggest that tumor seeding may have occurred during the needle biopsy.

Soft tissue metastases from differentiated thyroid cancer diagnosed by 18F FDG PET-CT / Metástases em tecidos moles de câncer de tireoide diagnosticadas por 18F FDG PET-CT

Distant metastases of differentiated thyroid cancer are unusual; lung and bones are the most frequently affected sites. Soft tissue metastases (STM) are extremely rare. We describe two cases of patients with differentiated thyroid cancer metastasizing to soft tissues. Both patients had widespread metastatic disease; clinically asymptomatic soft tissue metastases were found by 18-Fluordeoxyglucose positron emission tomography/computed tomography (18F FDG PET-CT), and confirmed by cytological and/or histopathological studies. These findings underscore the ability of 18F FDG PET-CT in accurately assessing the extent of the disease, as well as the utility of the method to evaluate regions of the body that are not routinely explored.

As metástases a distância em carcinoma diferenciado de tireoide são raras. Pulmão e ossos são os lugares mais frequentemente atingidos. As metástases em tecidos moles são extremamente infrequentes. Neste artigo, descrevemos dois casos de pacientes com câncer diferenciado de tireoide com metástases em tecidos moles. Ambos os pacientes padeciam de enfermidade avançada. As metástases em partes moles foram assintomáticas e detectadas mediante 18-Fluordeoxyglucose positron emission tomography/computed tomography (18F FDG PET-CT), sendo confirmadas por citologia e/ou histopatologia. Esses achados ressaltam o valor do 18F FDG PET-CT para a avaliação correta da extensão da enfermidade e a utilidade do método para avaliar regiões do corpo que não são exploradas nos estudos de rotina.

Cytologically diagnosed metastatic small cell lung carcinoma in the mandibular soft tissue

Metastatic tumors to the oral and maxillofacial region are relatively rare, they constitute 1% of all malignant tumors of the oral cavity. The purpose of this case report is to evaluate the efficiency of fine needle aspiration cytology [FNAC] in the diagnosis of metastatic small cell lung carcinoma. A 50-year-old female patient presenting with a 4x5 cm firm, hemorrhagic, tender swelling on the left mandibular bicuspid gingiva was evaluated. Her past medical history revealed a mass measuring 8x5 cm in the left pulmonary hilar area with pleural effusion, which was diagnosed as small cell lung carcinoma. A FNAC was performed to the oral mucosal swelling, and cytological examination revealed metastatic small cell lung carcinoma. The duration between diagnosis of the primary lung and development of metastasis was 6 months. The FNAC is a rapid, non-invasive, and safe diagnostic method when carried out with a proper technique, and proved to be a valuable adjunct to a careful physical and radiological examination of the oro-maxillofacial lesions

Spinal cord injury after conducting transcatheter arterial chemoembolization for costal metastasis of hepatocellular carcinoma

Transcatheter arterial chemoembolization (TACE) has been used widely to treat patients with unresectable hepatocellular carcinoma. However, this method can induce various adverse events caused by necrosis of the tumor itself or damage to nontumor tissues. In particular, neurologic side effects such as cerebral infarction and paraplegia, although rare, may cause severe sequelae and permanent disability. Detailed information regarding the treatment process and prognosis associated with this procedure is not yet available. We experienced a case of paraplegia that occurred after conducting TACE through the intercostal artery to treat hepatocellular carcinoma that had metastasized to the rib. In this case, TACE was attempted to relieve severe bone pain, which had persisted even after palliative radiotherapy. A sudden impairment of sensory and motor functions after TACE developed in the trunk below the level of the sternum and in both lower extremities. The patient subsequently received steroid pulse therapy along with supportive care and continuous rehabilitation. At the time of discharge the patient had recovered sufficiently to enable him to walk by himself, although some paresthesia and spasticity remained.

Liposarcoma pleomórfico metastásico: presentación de un caso / Metastatic pleomorphic Liposarcoma: a case presentation

Se presenta una paciente de 75 años de edad, aquejada de dolor lumboabdominal derecho, manifestaciones generales y hemoptisis. Al examen físico se constata palidez cutáneomucosa, lesiones hemorragíparas de la piel, tumor axilar izquierdo, estertores crepitantes en base pulmonar izquierda y hemiplejia izquierda total directa y proporcional. Se realizan estudios imagenológicos que revelan lesiones tumorales en abdomen y cráneo. La citología del tumor axilar fue compatible con un liposarcoma pleomórfico.

A patient of 75 years old, afflicted of right lumboabdominal pain appears, general manifestations and hemoptysis. To the physical examination it has been confirmed mucocutaneos pallor, hemorrhagic lesions of the skin, left axilliary tumor, crackle death rattles in left pulmonary base and left direct hemiplegia and proporcional total. Imagenologic studies are realized that reveal tumorlike lesions in abdomen and skull. The axillary tumor cytology was compatible with a pleomorphic liposarcoma.

A Case of Benign Metastasizing Leiomyoma with Multiple Metastasis to the Soft Tissue, Skeletal Muscle, Lung and Breast

Benign metastasizing leiomyoma (BML) is composed of well-differentiated smooth muscle cells and dense connective tissue. BML affects middle-aged women who have had previous hysterectomies due to a histologically benign-appearing uterine leiomyoma. We report here on a case of BML from the uterine leiomyoma in a 39-year-old woman that involved the soft tissues, skeletal muscles, lungs and breasts. She underwent a hysterectomy for the uterine leiomyoma, double oophorectomy for hormonal ablation and lung wedge resection to confirm the diagnosis. The microscopic findings of the breast and lung tumor were similar to those of the benign uterine leiomyoma. Therefore, we consider that these lesions were breast and pulmonary metastases of the uterine leiomyoma. We report here on a rare case of benign metastasizing uterine leiomyoma that involved the soft tissue, skeletal muscles, lungs and breasts, and we include a review of the relevant literature.

Metastasis of Transitional Cell Carcinoma to the Lower Abdominal Wall 20 Years after Cystectomy

Iatrogenic implantation has been the main cause in the majority of cases of transitional call carcinoma (TCC) with metastasis to the abdominal wall. A 66-year-old woman had undergone radical cystectomy 20 years prior to presenting. Radiological investigations revealed one mass in the left lower abdominal wall and one mass in the right inguinal area. She underwent wide excision of the lesions that revealed metastasis of TCC. This report describes this case of a woman with bladder carcinoma who developed a metastasis in the anterior abdominal wall following an apparent disease-free interval of 20 years.

Follicular carcinoma of thyroid with synchronous bony and soft tissue metastases.

A 65 years old lady presented with a large thyroid swelling along with a soft, non-tender mass over the left parietal region and a small, hard, non-tender swelling over the volar aspect of right forearm. FNAC reports from the thyroid gland and the swellings over head and forearm all revealed features of follicular neoplasm. Excision biopsy of the forearm swelling showed histology of metastatic poorly differentiated follicular adenocarcinoma of thyroid. The patient underwent total thyroidectomy followed by excision of the mass over the head, a week later. She was discharged in favourable condition with advice to attend oncology department for subsequent management. She is yet to attend surgical outdoor for follow-up.

Tumor de células gigantes: relato de caso / Giant-cell tumor: report of a case

Os autores apresentam um caso de tumor de células gigantes do osso que recidivou para as partes moles sete anos após o tratamento.

Amputaçäo interescaprulotorácica (AIET): indicaçöes, técnica e tática cirúrgica / Interscapulothoracic amputation indications and surgical technique

Os autores apresentam as indicaçöes, a técnica e a tática cirúrgicas da amputaçäo interescapulotorácica (AIET) para o tratamento das neoplasias malignas primárias ou metastáticas. Os tempos operatórios encontram-se bem ilustrados obedecendo aos princípios de cirurgia oncológica atual